Individual
THOMAS JOE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
800 CLINIC CIRCLE, FAIRMONT, MN 56031
(507) 235-5985
Mailing address
PO BOX 800, 800 CLINIC CIRCLE, FAIRMONT, MN 56031
(507) 235-5985
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9502
MN
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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